RESUMO
It is well established that a feeding jejunostomy is an invaluable adjuvant for use in critically ill and malnourished patients. What is not well known are the complications of inserting these tubes. Some surgeons are reluctant to insert feeding tubes unless the indications are very clear. From their experience with the insertion of 133 feeding jejunostomy tubes during a 3-year period, the authors conclude that the complications associated with the insertion of such tubes are few and that the procedure is justified even if the tube is never used.
Assuntos
Jejunostomia , Nutrição Enteral , Feminino , Gastroenteropatias/etiologia , Humanos , Infecções/etiologia , Jejunostomia/efeitos adversos , Masculino , Fatores de TempoRESUMO
Fifty-four patients receiving peripheral parenteral nutrition consisting of 3.5 percent amino acids in a 5 percent dextrose solution were randomly assigned in a double-blind fashion to receive this solution with or without an antiphlebitic mixture (1000 IU heparin, 5 mg hydrocortisone, and 1.8 mEq sodium hydroxide as a buffer). The addition of antiphlebitic mixture resulted in a marked and highly significant reduction in the incidence of phlebitis and a prolongation of the number of phlebitis-free hours during infusion of peripheral parenteral nutrition (p less than 0.005).
Assuntos
Nutrição Parenteral , Flebite/prevenção & controle , Idoso , Aminoácidos/administração & dosagem , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Glucose/administração & dosagem , Heparina/administração & dosagem , Humanos , Hidrocortisona/administração & dosagem , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral/efeitos adversos , Distribuição Aleatória , Hidróxido de Sódio/administração & dosagem , Fatores de TempoRESUMO
We previously demonstrated unacceptably high failure rates with horizontal gastroplasty. Shortly thereafter, vertical banded gastroplasty was introduced. Since April 1982 we have operated on 56 patients who were carefully selected and closely followed. There were 10 men and 46 women, aged 15 to 54 years (mean age 36 years) with preoperative weights of 93.5 to 198.6 kg (mean 125.9 kg). The mean weight loss at 6 to 12 months was 36 +/- 10 kg, or 30% of body weight. At 18 months, data were available for 48 of the 56 patients. Their weight losses were 44 +/- 11 kg, or 35% of body weight. Eight patients were lost to follow-up. The weight of nine additional patients plateaued before they lost 30% of their starting weights and another eight patients have started to regain weight after achieving satisfactory weight loss. Included are two patients with severe stenoses who regained all weight lost.
Assuntos
Obesidade/terapia , Estômago/cirurgia , Adolescente , Adulto , Sulfato de Bário , Peso Corporal , Feminino , Seguimentos , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Radiografia , Reoperação , Estômago/diagnóstico por imagem , Grampeadores CirúrgicosRESUMO
Thirty patients who received routine intravenous therapy (3.3% dextrose and 0.3% normal saline at a rate of 100 mL/h) were randomized prospectively into two groups to receive an antiphlebitic mixture of heparin-hydrocortisone-sodium bicarbonate or placebo in a double-blinded fashion for 4 to 7 days. The code was then broken and the data were analysed using chi 2 analysis with respect to the clinical grade and incidence of phlebitis. Phlebitis developed in 2 of 14 study and 10 of 16 control patients. All study patients tolerated their intravenous lines longer and needed less restarting. The antiphlebitic mixture effectively prevented superficial infusion phlebitis in patients receiving dextrose-saline solutions.